The Research Of Correlation Between Umbilical Cord Nucleated Red Cell Count,the Levels Of IL-6,IL-10 And Infections In Preterm Neonates

ObjectiveTo evaluate the relationship between NRBCs count,IL-6,IL-10 and preterm neonates complicated by infection and also to analyze its value for the forecast of premature infectious diseases by examining umbilical cord blood NRBCs counts,the ratio of NRBC/CBMNC and the serum concentrations of IL-6,II-10 of infection and none infection groups.Methods1.55 preterm newborns who delivered at obstetrics and gynecology in Subei People’s Hospital from Aug 1,2017 to Jan 31,2018 and admitted in neonatal department are included in this study.All of them are born at gestational age greater than or equal to 28 weeks but less than 37 weeks,with birth weight less than 2500g.Among them,28 cases complicated with infection,the rest 27 cases returned to none infection control group.The diagnostic criteria of neonatal infectious diseases references to relevant sections of the fourth edition of "The Practical Neonatology".The data of all the objects were collected,including gestational age,birth weight,gender,and peripheral blood leukocytes(WBC),c-reactive protein(CRP)immediately collected after admitted.2.All the preterms’ umbilical venous blood were made blood smears,then observed by Wright staining to calculate the counts of NBRCs.And the rest umbilical venous blood were made CBMNC suspension,then measured by flow cytometry to evaluate the frequency of the CD71+CD235a+ cells in CBMNC.3.Evaluating the serum concentrations of IL-6,IL-10 of umbilical cord blood by ELISA method.4.SPSS21.0 software was used for statistical analysis.Results1.Basic data contrast:in the infection group,there were 13 cases of neonatal pneumonia,12 cases of sepsis,1 case of neonatal pneumonia complicated with sepsis,2 case of congenital syphilis.There was no statistically difference in subjects of gestational age,birth weight,gender,maternal age and delivery mode(P>0.05),or the subjects of CRP in peripheral blood(P>0.05).But the WBC count of the infection group was higher than the none infection group(P<0.05).2.NRBCs count contrast:(1)NRBC/100WBC count of the infection group was 16.3±7.7,significantly higher than that of the none infection group which was 5.5±3.1NRBC/100WBC,and the NRBCs count of two groups showed significant differences(P<0.001).The area under ROC curve of NRBCs count for the diagnosis of preterm infection was 0.969.When NRBCs count was greater than 9.5/100/100WBC,the diagnostic sensitivity and specificity were 92.9%and 85.2%.(2)The results showed a significant increase in the percentage of CD71+CD235a+ cells in the infectious compared with the none infectious group(20.28±10.44 vs.5.94±3.71,P<0.001).The area under ROC curve of the NRBC/CBMNC percentage for the diagnosis of preterm infection was 0.960.When NRBC/CBMNC was greater than 10.08%,the diagnostic sensitivity and specificity were 89.3%and 88.9%.3.The expression of IL-6 and IL-10:compared the two groups,the serum concentrations of IL-6,IL-10 in the preterm infection were significantly higher than that of the none infection control group,and difference was statistically significant(P<0.001;P<5.500).4.The levels of IL-6 and IL-10 in the infection group was linearly related to the percentage of NRBC/CBMNC(R2 = 0.808;R2-0.820).I outher words,the higher the NRBC/CBMNC%,the stronger the expression of IL-6 and IL-10.Conclusions1.The NRBCs count,the proportion of NRBC in CBMNC and IL-6,IL-10 in cord blood of the premature infection neonates were higher than that of the preterm without infections,what indicates that the NRBCs count,NRBC/CBMNC%and IL-6,IL-10 all participate in the progression of premature infectious diseases and have great clinical significance for the early diagnosis of premature infectious diseases.That NRBCs count greater than 9.5/100 WBC or NRBC/CBMNC higher than 10.08%indicates high possibility of infectious diseases in premature in their early life after birth.2.The cord blood IL-6,IL-10 were positively correlated NRBC/CBMNC%in infectious premature infants,which indicate that IL-6,IL-10 may participate in the immunoregulatory effects of NRBCs in the premature infection.